How My View of DSMES Changed After Credentialing - Burroughs
Oct 1, 2026, 09:00 AM
By Brian Burroughs, MSPAS, PA-C, AQH, BC-ADM, CDCES, CHC
Before pursuing the CDCES credential, I understood DSMES in theory.
I knew it was recommended. I knew it improved outcomes. I knew I should refer patients.
But if I am being honest, I often saw it as an adjunct to care rather than a central component of it.
That perspective changed significantly after going through the credentialing process.
What I came to appreciate is that DSMES is not an add-on. It is foundational.
In early practice, I often approached diabetes visits with a focus on clinical metrics. A1C, medications, labs, and guideline targets shaped much of the conversation. While these elements remain important, they do not fully capture what determines success in diabetes care.
After becoming a CDCES, I began to shift my focus toward how patients are actually managing their condition day to day.
- Are they confident in using their medications?
- Do they understand how food affects their glucose?
- What barriers are they facing that are not immediately visible in the chart?
These questions changed the way I structure visits.
I also became more intentional about incorporating DSMES principles directly into routine care. Even when a formal referral is not possible, elements of education, goal setting, and problem solving can still be integrated into brief clinical encounters.
Another important shift was recognizing the value of timing.
Previously, I thought of DSMES referrals as something to consider at diagnosis or when things were not going well. Now, I see DSMES as beneficial across the entire continuum of care, including transitions, medication changes, and periods of life disruption.
Perhaps the biggest change, however, was in how I view success.
Success is not just an A1C target. It is a patient feeling confident in their ability to manage their diabetes. It is reduced distress. It is sustainable behavior change.
DSMES supports all these outcomes in ways that medication adjustments alone cannot.
For clinicians who have not yet deeply engaged with DSMES, I would encourage taking a closer look. Whether through formal credentialing or simply partnering more closely with diabetes care and education specilaists, there is tremendous value in integrating this approach into everyday practice.
It has certainly reshaped mine.